June 16, 2017

Kasich backs gradual phase out of Medicaid expansion

Ohio Gov. John Kasich said last week that he could accept a gradual phase out of the expansion of Medicaid under the Affordable Care Act, but only if Congress provides states with more money than the House health care bill included and more flexibility to manage the health program for the poor (Source: “John Kasich Backs Slow Medicaid Rollback, but With More Money,” New York Times, June 12, 2017).

“I don’t have a problem with phasing down the enhanced federal payments,” said Kasich, who is working with several other Republican governors from states that have expanded Medicaid. “But it can’t be done overnight, and it has to be done with the resources and the flexibility that are needed so people don’t get left behind. You just can’t be cutting off coverage for people.”

Senator Mitch McConnell of Kentucky, the majority leader, had hoped to get a vote on a health reform bill by the end of this month, but it is looking more likely that it may not come until July.

Twenty Republican senators come from states that have expanded Medicaid, including Sen. Rob Portman of Ohio.

The future of Medicaid remains a divisive issue among Senate Republicans, but several weeks of intense negotiations behind closed doors have clarified the situation: The question for most Senate Republicans is no longer whether to end the expansion of Medicaid, but how fast.

Thirty-one states, including Ohio, have expanded Medicaid, with the federal government paying at least 90 percent of the costs for newly eligible beneficiaries. Moderate Republican senators say they are pushing to reduce the federal payments gradually over seven years, from 2020 to 2027. By contrast, the repeal bill passed by the House in early May would abruptly end the extra federal contributions for people added to the rolls in 2020 or later.